Scott A. Smolka1 LDS 102, S17 2/7/06 Scott A. Smolka Department of Computer Science Stony Brook University

Scott A. Smolka2 LDS 102, S17 2/7/06 Organ & Tissue Donation – A Complex Process Organ & tissue donation involves complex series of events requiring teamwork among physicians, nurses, hospital staff and procurement & transplant teams strict legal guidelines must be carefully followed before death can be declared Organs removed only after death is declared Doctors that treat patient at time of death no way involved with those responsible for organ removal Donation is considered only after every effort has been made to save patient’s life

Scott A. Smolka3 LDS 102, S17 2/7/06 Organ & Tissue Donation – A Complex Process Step 1: When potential donor identified by hospital staff, local procurement organization contacted. Team of organ & tissue procurement specialists and family counselors available 24/7 Step 2: Procurement coordinator evaluates potential donor through series of tests to determine organ & tissue suitability. If HIV infection or active cancer are present, case not suitable for donation Step 3: Next of kin must be informed of opportunity to donate relative’s organs & tissues, and must give permission. Procurement coordinator (or family counselor) explains donation to family and presents necessary paperwork after consent given

Scott A. Smolka4 LDS 102, S17 2/7/06 UNOS’s role in the Organ Donation Process Step 4: After consent obtained, search made for most appropriate recipient(s) using computerized listing of all transplant candidates in the US ( List managed by United Network for Organ Sharing (UNOS). National computerized system ensures organ allocation done fairly across nation.United Network for Organ Sharing Ranking for transplant candidate dependent upon genetic markers & blood match, urgency of need, waiting time on list, weight & age, and proximity to the donor Coordinating matching efforts with local procurement organization, UNOS attempts to match organ with local transplant candidate first. If no match found, attempt to match organ statewide and then nationally

Scott A. Smolka5 LDS 102, S17 2/7/06 Tissue Donation Tissues, such as skin, bone and eyes, are tested and processed for transplantation by state-certified processing centers, and can be stored for varied lengths of time. For example, an eye bank can store corneas for up to seven days. Other tissue can be stored for up to five years. Local tissue banks manage inventory of specific tissue based on needs of region they serve

Scott A. Smolka6 LDS 102, S17 2/7/06 Transplantation Surgery Step 5: Recovery of organs & tissues performed in hospital operating room just like other standard operations Once removed, donor organs & tissues transported to the transplant centers(s) where transplant recipient(s) waiting for surgery Time critical since organs only viable for transplant between 4 and 72 hours (time varies by organ) Recipient’s diseased or failing organ removed and donated organ is transplanted

Scott A. Smolka7 LDS 102, S17 2/7/06 Organs: Functions & Applications ORGANFUNCTIONTHOSE WHO WILL BENEFIT heartPumps blood to all body systemspatients suffering from severe, life-threatening heart failure small intestine digestive organ that absorbs water, electrolytes and nutrients for the body patients suffering from severe, life-threatening digestive system failure--malabsorption, a disease that prevents the absorption of necessary nutrients kidney (2)extracts waste from the blood and produces important hormones patients suffering from kidney failure -- a transplant eliminates the need for dialysis liverinstrumental in energy regulation, makes proteins, removes waste from blood patients suffering from life threatening liver failure from hepatitis, cirrhosis auto immune diseases and birth defects

Scott A. Smolka8 LDS 102, S17 2/7/06 Organs: Functions & Applications (continued) ORGANFUNCTIONTHOSE WHO WILL BENEFIT lung (2)organ of respirationpatients suffering from cystic fibrosis, emphysema, or other life-threatening lung disease pancreassecretes enzymes necessary for digestion, secretes insulin that helps regulate blood sugar insulin dependent diabetic patients for treating diabetes, transplant eliminates the need for insulin injections, reduces risk of losing sight or limb

Scott A. Smolka9 LDS 102, S17 2/7/06 Tissues: Functions & Applications TISSUEFUNCTIONAPPLICATION bone - femur, humerus, ilia, tibia, ribs & fibula supports the body, protects vital organs Patients requiring facial reconstruction, limb salvage preventing amputation, correction of birth defects, cancer treatment, spinal fusion and oral surgery cartilageconnective tissue that serves as skeletal tissue in some parts of the body, i.e., nose & outer ear Patients needing facial and other reconstruction corneasallow light to enter the eyePatients suffering from corneal blindness restoring their sight fasciafibrous tissue that covers the musclesrestores mobility to patients needing tendons & ligaments repaired heart valvesdirect flow of blood through heartpatients requiring replacement of diseased heart valves; (donor valves usually preferred over mechanical valve)

Scott A. Smolka10 LDS 102, S17 2/7/06 Tissues: Functions & Applications (continued) TISSUEFUNCTIONAPPLICATION ligamentsstrengthen bone jointsfor use in patients with joint injuries middle eartissue of hearingfor patients with damaged middle-ear structures skinprotects the body from dehydration, injury and infection treatment for burn patients, decreases pain, infection, scarring, heat and fluid loss tendonsattach muscle to bonefor use in patients with joint injuries, often related to sports injury veinstransport bloodfor patients requiring coronary by-pass surgery to replace diseased or blocked arteries

Scott A. Smolka11 LDS 102, S17 2/7/06 Organs & Tissues that can be Donated Eyes / Corneas Heart & Heart ValvesLungs Liver Kidneys Pancreas Small Intestines Saphenous Veins Bone Skin Tendons

Scott A. Smolka12 LDS 102, S17 2/7/06 Skin Transplants & Burn Wounds Skin is a complex organ: protection of body against invasion by microorganisms, conservation of fluids & electrolytes, regulation of body temperature Primary aim of burn therapy is closure of burn wound. Survival from burn injury directly related to size of wound. In larger burns, not enough unburned area to use as a donor site to graft entire burn all at once. In these cases, deceased donor skin or allograft plays major role in increasing survival of burn patient. As donor sites become available with healing of partial-thickness wounds, allograft replaced with autograft

Scott A. Smolka13 LDS 102, S17 2/7/06 Skin Transplants & Burn Wounds (continued) Removal of split-thickness skin from a deceased donor takes place in the operating room using sterile techniques Skin taken in strips using a dermatome. Approximately 15/1000 inch thick, almost thin enough to see through. Areas from which skin has been removed not disfigured. Skin not taken from any areas that would show at a funeral For men, women, and children of all races & ages who are fighting to recover from life-threatening, potentially disfiguring burns, Skin Bank is a bank of hope and promise for the future

Scott A. Smolka14 LDS 102, S17 2/7/06 Guest Lectures (please see Course Calendar) 2/14: Dave Bekofsky, Administrator for the Transplant Program, Stony Brook University Hospital Dave will focus on process of listing, choosing & transplanting and ethical issues surrounding entire organ donation process including: latest ethical issues regarding advertising and internet seeking for donation. Please visit great deal of information regarding organ transplantation & donationwww.unos.org 2/21: Christine Galan, Heart-Liver Recipient & organ- donation advocate

Scott A. Smolka15 LDS 102, S17 2/7/06 Course Project Let’s pick single course project for all of us to work on Prevailing opinion seems to favor 5K walk/run for organ & tissue donation awareness Need to choose date/time Any collateral events? Celebrity speaker?

Scott A. Smolka16 LDS 102, S17 2/7/06 To Do List Get all required permissions & waivers Make all necessary reservations Obtain necessary materials: tables, donor cards, etc. Publicize the event Arrange for media coverage Etc. etc.

Scott A. Smolka17 LDS 102, S17 2/7/06 Things to Do this Week Visit and Get started on your role in term project Enroll at least one person in the New York State Organ and Tissue Donor Registry Discuss organ and tissue donation with your family